Individual
ANTOINETTE ALEXANDRIA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
8350 CRAIG ST, INDIANAPOLIS, IN 46250-3593
(317) 578-0410
Mailing address
8350 CRAIG ST, INDIANAPOLIS, IN 46250-3593
(317) 578-0410
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-36874
IN
Other
Enumeration date
07/23/2020
Last updated
11/08/2022
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